Osteoporosis: Is there a place for new therapeutical approach?

Osteoporosis is a prevalent condition that is associated with an increased susceptibility for fractures. In the past few years, several drugs have become available that can substantially reduce the incidence of fractures in patients with osteoporosis. Since these drugs work through different cellular mechanisms, it might be expected that combining agents of different classes could have an additive effect on fracture risk reduction. Combination treatments that have been evaluated in clinical trials include estrogen/bisphosphonates, raloxifene/ bisphosphonates, PTH/ bisphosphonates and PTH/ estrogen combinations. These trials have shown increases in bone mineral density over what occurs with each agent alone. However, further research is needed to demonstrate those results over longer periods of time, and to examine anti-fracture efficacy because fracture outcome is the ultimate targets for osteoporosis treatment. This article reviews the individual agents currently available for the management of the disease, and the combination treatments that have been evaluated in clinical trials, with a discussion of the potential benefits and risks that those treatments entail. Integrating safety and cost issues will eventually determine whether those combinations will become standard of care.